Any other mental health professionals on here?

[ShrinkInterrupted]

Psychiatrist here. Not finding it easy at the moment (understatement) and thinking of leaving. Difficult to work out if it's me, or the job. Just wondered how everyone else is finding it.

I work in acute services crisis and inpatient and I'm afraid it did feel unfair and still does and that has contributed to my misery.
We just had to carry on in acute with a plastic pinny and a paper mask to protect us (hence we all got Covid) vs in community services they just stopped. They cancelled clinics altogether and then went to online wfh only. I feel some of my colleagues got rather too used to this and are reluctant to step back up and have got used to binning all the face to face (aka difficult and risky) work on me. I am resentful. We were all getting paid the same.
Then because I am the one standing there I get to field the blame and anger because 'my mums been waiting 6 months, getting worse and worse, no-one would come out, it's a bloody disgrace' I want to say that yes it is I agree but obviously I don't.

Lollipop thank you for that
I do think I may well objectively be depressed but can't see it myself
I did have a post natal episode as a registrar and it took my consultant to tell me that.
I was really only half joking about the SSRI. I am trying to work up courage to see my GP about it.

@CovoidOfAllHumanity - I really hear you re the face to face stuff vs wfh/online approach of community colleagues

It felt very unfair at times. Some service provision stopping all face to face yet inpatient and crisis services having to carry on (how could they not?!) but with massively increased workloads and stress levels

Oh yes @CovoidOfAllHumanity
This is my experience too.

And to add insult to injury when I have to reflect with managers of other teams why their patients are strangely “going into crisis” all the time - the conversations are very difficult. The conversation gets derailed into why my Team are being ‘difficult’ not mopping up after everyone else.

Some teams still do lots of telephone calls to patients, side stepping any patient requests to be seen face to face.They take huge offence when we suggest perhaps they could actually visit the patient even just once to properly review before making a panicked referral to urgent care at 2pm.

These other managers are quite happy sending ranty emails from the comfort of their sofas. And those clinical staff in their teams mainly follow the managers lead. The few decent ones who physically come into work are completely overwhelmed. They do all their own work and then have to be polite when their so called colleagues try to delegate more onto them. I know this because they come and chat to me about their concerns as their own managers are unavailable most of the time…and I am approachable and a great believer in working with and not against other teams.

Sorry to hear everyone’s difficult experiences.

I’m also feeling pretty burnt out. I’m dealing with it by paying very special attention to my personal development/SPA time to try build skills to expand my options a bit. Just making plans around this has helped my mood a bit so something you might want to consider.

@verytired42
That’s good advice thank you.

I’ve gone into what I call ‘enhanced self care mode’
Really trying to eat properly, swim a couple of times a week.
Leave my laptop and work phone locked up at work some nights so I literally can’t log on!

I am sorry we are all having such a hard time

The pattern at my Trust seems to be:

• a wave of stable, experienced practitioners in the same posts for years (consultants, CPNs etc) quietly counted down to their MHO status retirement and got out 5-10 years ago.

• they were replaced with a revolving door of new starters who burn out rapidly due to the increasing acuity, unrealistic demands, lack of safety, lack of support / supervision etc. Leading to no stability, no support for new starters, etc.

There are now whole services which can't recruit. And the remaining staff naturally don't want to work in an unsafe, failing service, so move elsewhere, compounding the problem. People don't get the care they need so shift along the crisis spectrum by the time they are seen, so acuity is worse and outcomes poorer, and the pattern continues.

I do think there is also an issue with mental health services being held accountable for fixing issues where they should be some personal responsibility taken - eg choosing to stop taking medication against medical advice, using drugs, etc. Support, education, availability of help - absolutely our remit - but that's different to the current expectation which seems to be we are responsible for stopping people doing bad things. That's unrealistic.

@ShrinkInterrupted
Yes totally agree.

And along the same lines there needs to be some sort of National ‘announcement’ for want of a better word.

The government needs to make it crystal clear to ALL users of the NHS that the following changes have been made (by them or previous governments) nationally and are not the fault or choice of individual mental healthcare professionals.

These include various cutbacks and review of services.
Leading to a choice to reduce the number of beds.
Massive changes to education impacting especially on nurse provision and other professionals.
An end to long term service from CMHTs
Vast reduction in day services and other respite type provision.

Services in some areas being privatised or practically privatised e.g. alcohol services.

A move towards paying charities such as MIND to provide a service. Patients often see a referral outside of the NHS as being inferior and being fobbed off - accusing my clinicians of not giving them what they perceive they would have previously been offered, such as admission or a long term CPN.

I often reflect that if I had a physical health problem and felt I needed an operation, unless I pay privately I have to accept my GP decision and agree to (for example) medication or physiotherapist. And if I didn’t want that I couldn’t start demanding a bed regardless. In mental health some of our patients seem to think a bed can be demanded as a right and are reluctant to engage with discussion about more appropriate alternatives.

And on the subject of self-responsibility. If someone is referred to say MIND counselling or other therapy but chooses not to engage that is fine and their choice. What isn’t fine is then self referring back to the NHS and taking offence when the healthcare professional explores why they didn’t access the therapy. We don’t have a whole list of other better options that we deliberately withhold - but can then give out if the patient complains…

@ShrinkInterrupted

I think the point you make about personal responsibility is an interesting one. I do believe there is an expectation that MH services can provide cures and fixes, when we know that it is so much more complex than that

I also feel that in the last few years particularly there has been much more of a ‘national conversation’ about mental health… it’s on the news more, it’s all over social media. It’s being given a higher profile - eg the young royals talking about it, reports on tragic deaths of reality TV contestants and presenters. As a result we are encouraged to ‘reach out’, to ask for help, to let others know we are struggling. And OF COURSE this is a good thing and anything that de-stigmatises mental illness is positive. But the reality is that services are not being resourced and funded to match the resultant increased demand.

I know that in my area we are leaning on and signposting so much more to third sector and voluntary services. But not sure how much more they’ll be able to take either

Hi everyone, another psychologist here. Bit fortunate that I have a role in a (previously) better resourced team than some, however even that is changing as we speak. Resource is dwindling and it’s been difficult to recruit to vacancies.

Another dedicated and very hard working colleague has just said they are leaving due to stress caused by the intensity of the workloads. It’s crushing that we are losing good staff to burnout when they are really the ones we’d most like to retain. It sometimes feels like people are being punished for their own diligence and compassion. Soul destroying indeed.

I must say that though I'm sorry to hear how we're all struggling, I am finding the solidarity of this thread very therapeutic! It's like my Balint days of yore, without the psychotherapist to keep us professional and boundaried and non-sweary

But I often ask myself if I'm just... doing it wrong? Is it my attitude? My own lack of resilience? I watched this video yesterday - why does this guy look happy? This is what I thought my job would be like when I chose psychiatry....

Very glad to find this thread!

I’m a psychotherapist and also struggling. I’m privileged in that I do work in private practice but the reality is that I feel increasingly isolated and am not good at the business side of being in pp.

I have been having increasing thoughts of changing to a different job like Waitrose or something similar.

Glad to know I’m not alone but sorry to hear there are so many others struggling.

“And on the subject of self-responsibility. If someone is referred to say MIND counselling or other therapy but chooses not to engage that is fine and their choice. What isn’t fine is then self referring back to the NHS and taking offence when the healthcare professional explores why they didn’t access the therapy. We don’t have a whole list of other better options that we deliberately withhold - but can then give out if the patient complains…”

Absolutely this, we may have limited time and resources but we really do try hard to give everyone some psychological work of value - an extended formulation, skills building, a course of goal focused CBT/EMDR, or counselling type sessions. What we can’t do is hand hold/provide non focused ‘support’, general support is not commissioned or is best accessed through non statutory services eg MIND, drug and alcohol, other charities.

If I’ve spent time with someone and worked on a formulation with some helpful ‘next steps’, drafted a thorough email with said suggestions, and then seen them again and they’ve not looked at any of it or even given it a second thought. Take some personal responsibility please, help us to help you!

Can I join in? Mental health nurse for 28 years. Always passionate about my job and patients and felt fortunate to have chosen ‘well’ in my career. Never ventured into management but well respected and nominated for various awards so can’t aleays have been crap at my job Last few years all interest passion (and some days, ability it feels) lost.
Had 6 months off sick last year due to a MH ‘episode’ severe anxiety and intrusive thoughts one big factor was the stress of not being able to offer very unwell patients anything worthwhile.
Think I’m more or less at the end of the line, sadly. Looking at retraining in something ‘nice’ like aromatherapy. Feel at 48 I’m too young to give a good and previously rewarding career but seems my brains given up so not much choice!

I want to join this thread even though I'm a GP (these days it's 50%+ mental health) because I relate. We're all burnt out too sadly. Fist bump to you all and thanks for what you do.

@ShrinkInterrupted

Also most, if not all, of my patients are the products of trauma and damage from abusive childhoods. Societal issues of drugs, poverty, neglect, abuse that I'm several decades too late to get to the real root of.

The prospect of, not only providing a grossly inadequate and therefore, often damaging service and also having to direct and manage staff to do that was enough for me to go.

@AnnieSnap - this resonated very strongly with me. This is what's happening in our service. I can't tolerate being in a supposed "leadership" position as a consultant and having to accept this.

It's so so true.

@ShrinkInterrupted
Thank you for starting this thread, you and the others who posted afterwards have all been very interesting and supportive.

What is helping me is remembering the many many patients I have helped, even over recent weeks - I hope that doesn’t sound big headed. I am sure we are all doing the absolute best we can under immense pressure. For example the lady I kept out of hospital (because hospital is less safe for her) I really gave of myself and provided intense and evidence based intervention. The chap who almost took his life, he is doing better now and he was kind enough to write a letter to me and my staff member to update us. I admit I cried and I have an anonymised version that I look at when I want to tell the NHS to F off.

This is true nursing and I’m still in (for now)

I never thought I would admit to feeling near to burn out, I had always (sorry to say) been a bit about the concept.

For most of us regardless of whether band 5/6/7 - nurse, psychiatrist AHP, GP or anyone I have missed, the reality is that the work isn’t going to get easier. ‘It is what it is’ as I said to my own manager. So we have to be honest with ourselves and very sadly if it makes us ill or regularly impacts on our own ‘real life’ then we have to consider if it is right to continue in the way we are.

I think I sort of fit in here.

I worked in frontline mental health services (mainly crisis support) for 10 years or so and moved into training about 20 years ago.

I don't have a 'proper' qualification eg RMN, Social worker, just years of experience although I haven't been able to find a job in more than a year of looking.

I hate what's happening to mental health. Services for those most in need cut to the bone and a plethora of well-being apps lining the pockets of venture capitalists for everyone else.

Massive respect to you frontline workers and all that you do.

Sorry to use this thread to ask questions, but I've been looking for a job now for a very long time and am trying to avoid applying for things where I'll get an interview and then be told that they've appointed someone with 'more relevant skills and experience'.

Over a year of it has been utterly soul destroying.

Is the Childrens and Young Peoples field (non-qualified so things like project worker/project co-ordinator etc) populated by people in their 20s/30s?

This is my impression based on the interviews I have had, and if it is the case, I'll stop looking in this area as I'm too old.

TIA

@Twitterwhooooo no not where I work, I don’t work in CAMHS but a close friend does. Her background was adult cmht then EIP now working as a CAMHS cpn , there’s a mixed age group in her team. It is difficult though if you don’t have a professional qualification- it shouldn’t be when you have years of experience in your field. Good luck in your job seeking

I'm a mental health nurse, almost 20 years in. I only work part time but I feel like I am reaching burnout. The lack of staff, the lack of support, the only thing we are able to do is cover patients very basic needs and very little else. Its awful. Even on the odd occasion we do have enough staff on a shift, it almost guaranteed that at least one will be moved to a different area. We are frequently left with dangerously low staffing numbers. And we have many high risk patients, in the sense that many have lots of physical health issues that require close monitoring, that 2 or 3 members of staff struggle to do when the ward has 16 patients. I feel constant anxiety around work, and feel like I can't think straight halfthe time.

[quote howardmoonseyebrow]@Twitterwhooooo no not where I work, I don’t work in CAMHS but a close friend does. Her background was adult cmht then EIP now working as a CAMHS cpn , there’s a mixed age group in her team. It is difficult though if you don’t have a professional qualification- it shouldn’t be when you have years of experience in your field. Good luck in your job seeking[/quote]
Thanks. I haven't applied for jobs that need a qualification obvs, more the 'project co-ordinator' type roles in mental health charities. Been interviewed by people half my age, which was excruciating all round.

I did apply for Educational Mental Health Practitioner training placements partly because they lead to a guaranteed job, but didn't get an interview, and wonder if my age was a factor (lack of relevant experience certainly wasn't!).

@Justcashnosweets

I'm a mental health nurse, almost 20 years in. I only work part time but I feel like I am reaching burnout. The lack of staff, the lack of support, the only thing we are able to do is cover patients very basic needs and very little else. Its awful. Even on the odd occasion we do have enough staff on a shift, it almost guaranteed that at least one will be moved to a different area. We are frequently left with dangerously low staffing numbers. And we have many high risk patients, in the sense that many have lots of physical health issues that require close monitoring, that 2 or 3 members of staff struggle to do when the ward has 16 patients. I feel constant anxiety around work, and feel like I can't think straight halfthe time.

I'm so sorry Justcashnosweets it's horrendous for people on the frontline now.

I’m a lead OT for a regional mental health specialities hospital. 27 years in the NHS and all in mental health. I burnt out before Christmas, mostly due to my personal life, but work doesn’t help. I’m slightly cheered to find I’m not the only one, in an awful way.

I get the feeling that I’m being watched carefully at the moment. Like I’m the canary in the mine.

I'm a few months away from qualifying as an OT - currently on placement on a forensic ward, but have also worked in CAMHS.

This thread definitely makes me worry about my chosen career path after spending the last few years retraining